05 introduction to injury scoring systems
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This document introduces several physiological injury scoring systems used in trauma, including the Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Acute Physiology and Chronic Health Evaluation (APACHE) score. The GCS measures level of consciousness on a 3 to 15 point scale. The RTS incorporates GCS, systolic blood pressure, and respiratory rate to predict survival. APACHE considers acute physiology variables and preexisting medical conditions.
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05 introduction to injury scoring systems
- 1. Introduction to Injury Scoring Systems Part 1- Physiologic Scores Amado Alejandro Báez MD MSc
- 14. The Revised Trauma Score 0 0 0 3 1 1-5 1-49 4-5 2 6-9 50-75 6-8 3 >29 76-89 9-12 4 10-29 >89 13-15 RTS Value Respiratory Rate (RR) Systolic Blood Pressure (SBP) Glasgow Coma Scale (GCS)
Editor's Notes
- Injury severity characterization formally began in 1969, with the development of the Abbreviated Injury Scale (AIS).
- Teasdale and Jennet initially published the Glasgow Coma Scale in 1974 and later modified in1976 to include withdrawal as part of the motor component.
- The RTS is heavily weighted towards the Glasgow Coma Scale to compensate for major head injury without multisystem injury or major physiological changes.
- The main advantage of the coded RTS is that the weighting of the individual components emphasizes the significant impact of traumatic brain injury on outcome.
- An RTS of less than 11 is used to indicate the need for transport to a designated trauma center.
- Champion HR et al, "A Revision of the Trauma Score", J Trauma 29:623-629,1989 Champion HR et al, "Trauma Score", Crit Care Med 9:672-676,1981
- The Acute Physiology and Chronic Health Evaluation (APACHE) was introduced in 1981, is widely used for the assessment of illness severity in intensive care units.
- In 1985, the APACHE system was revised (APACHE II) by reducing the number of APS variables to 12 (from 34), restricting the co morbid conditions, and deriving coefficients for specific diseases. APACHE II is the most widely applied APACHE system.